Feil Katharina, Ruf Benjamin, Behling Felix, Kozak Gabor, Gohla Georg, Riessen Reimer, Haap Michael, Poli Sven, Hennersdorf Florian, Ziemann Ulf, Mengel Annerose
Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany.
Department of Internal Medicine I, University Hospital Tübingen, University of Tübingen, Tübingen, Germany.
Front Med (Lausanne). 2025 Aug 29;12:1627241. doi: 10.3389/fmed.2025.1627241. eCollection 2025.
We report a rare case of severe -associated acute disseminated encephalomyelitis (ADEM) in a previously healthy 26-year-old woman. The patient presented with delayed-onset encephalopathy following a mild respiratory infection. Rapid neurological deterioration, signs of transtentorial herniation, and refractory intracranial hypertension necessitated emergency decompressive hemicraniectomy. Diagnostic workup revealed elevated IgM and borderline PCR positivity. The patient was successfully treated with corticosteroids, intravenous immunoglobulin, and targeted azithromycin. Complete clinical and radiological recovery was achieved. This case emphasizes the need for awareness of severe -associated CNS manifestations and highlights the challenges in diagnosis and management.
我们报告了一例罕见的严重相关急性播散性脑脊髓炎（ADEM）病例，患者为一名此前健康的26岁女性。该患者在轻度呼吸道感染后出现迟发性脑病。快速的神经功能恶化、小脑幕切迹疝体征和难治性颅内高压需要进行紧急减压性颅骨切除术。诊断检查显示IgM升高且PCR呈临界阳性。患者接受了皮质类固醇、静脉注射免疫球蛋白和靶向阿奇霉素治疗，最终成功治愈。实现了完全的临床和影像学恢复。该病例强调了需要认识到严重相关的中枢神经系统表现，并突出了诊断和管理方面的挑战。
